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Palliative Care and Hospice
It should be noted that Palliative Care and Hospice Care vary from province to province,
so we have tried to write this chapter universally.
What is Palliative Care?
Palliative care may also be referred to as hospice palliative care or end-of-life care.
Palliative care is a service that provides specialized care to patients who have been
diagnosed with a life threatening illness, regardless of age, diagnosis or stage of the
diagnosis. In all provinces, palliative care programs often collaborate with a variety of
health care professionals including, but not limited to “palliative care specialist, nurses,
family doctors, social workers, spiritual care providers, occupational therapists,
physiotherapists, home care and personal support workers, volunteers, and
pharmacists.” (Taken directly from Canadian Virtual Hospice. www.virtualhospice.ca)
Palliative care programs are not regulated on a national level, so the programs may
differ from province to province,
“In Canada and around the world, quality palliative care:
focuses on the concerns of patients and their families;
pays close attention to physical symptoms such as pain, nausea, loss of appetite and confusion;
considers the emotional and spiritual concerns of patients and families;
ensures that care is respectful and supportive of patient dignity;
respects the social and cultural needs of patients and families;
uses a team approach that may include volunteers, social workers and spiritual leaders in addition to medical staff.”
(this information has been taken directly from Canadian Virtual Hospice. http://www.virtualhospice.ca)
providing social, psychological, cultural, emotional, spiritual and practical support
**Patients are receiving palliative care when their health care providers are treating pain
and other symptoms of their illness.
Palliative care can be provided in a variety of locations depending on the needs of the patient, family and services available. As stated earlier, these will vary from province to province. It is important to understand each of the following and to ASK what is available in your province, so that you can ADVOCATE for the best program for yourself or your loved one.
Home Care Programs~
Home care programs are delivered from the patients/families home. These home care programs come in a variety of forms, services and program names. Home care programs offer a variety of services and are offered for different time periods and for different amounts of time (weekly, hourly). The services provided may or may not include; professional nursing care, medical care, pain / symptom management care, personal care, cleaning, cooking, companionship, transportation, hospice volunteers, physicians, telephone support etc.
Many of the programs can be accessed for free, through a referral process however other programs may involve a cost, especially if the company you use is a private company.
Palliative care in a residential hospice means that you or your loved one will receive full time palliative care in a setting that is made to feel “home like.” Residential hospice may also offer “respite care.” Respite care means temporary care away from home for the patient. Respite care provides caregivers with the opportunity to get some rest for a few days at a time. Due to the lack of residential hospice homes in Canada, most of these facilities can only offer beds to those who are in the late stages of life.
Once in the residential hospice setting, staff will pay close attention to physical symptoms. The goal is to keep the patients as comfortable as possible, so staff will treat you or your loved one accordingly. Staff will also work to ensure that emotional and spiritual needs are met.
Residential hospice care in most cases is not covered by the public health care system, so the family or patient may be required to pay an additional daily fee.
Hospitals have staff who have received specialty training within the palliative care field. They not only work with the patient and the families but also with the patients health care providers.
Although hospitals vary depending on provinces and resources most hospitals have a palliative care ward or a unit. These wards or units are often used to manage symptoms that are more complex or difficult. They often try to create a room for you or your loved that that has privacy and a “home like” feel to it.
Like the residential hospice homes, palliative care units or wards within hospitals may be short term and may also be used to manage specific symptoms. Once symptoms are managed you or your loved one may be moved to another unit of the hospital or outpatient facility or resource.
Personal Care Homes ~
Personal care homes are also referred to as nursing homes. These personal care homes or nursing comes provide regular palliative care. It is important to understand that you do not have to be a long time resident to receive palliative care services within a nursing home. Once again, nursing home facilities often have access to teams that have specialized training in palliative care. They will work with the patient, the family and health care providers to ensure that symptoms are managed and that the patient is made as comfortable as possible. Many of the staff are also trained in helping families and caregivers make difficult decisions.
What is the difference between palliative care and hospice care?
Hospice care and palliative care programs share very similar goals. Both provide symptom relief, pain management and provide support to both patients and caregivers as they navigate through a serious illness. Both services are to be used as an additional layer of support and services.
Palliative care services are offered to patients when diagnosed with a serious illness. This serious illness is can involve a terminal diagnosis, complex illness for extended periods of time, or whether they are expected to recover. Palliative care can be offered at any age of the patient and stage of the disease. It can be offered along with a curative treatment.
Hospice care quite often offers many of the same services of palliative care, however the services is used predominately for patients who have only a few months left to live.
When choosing either palliative care or hospice care for yourself or your loved one it is
important to understand;
~how each service works in your province.
~the services provided by both.
~how each program is funded.
Things to consider
Many families find the financial burdens difficult and challenging, during times of illness. Some hospital foundations may have financial support programs to aid patients and caregivers. Do not be embarrassed to ask about these programs, as they were developed for this very purpose. Asking for a referral to a Social Worker is often the way to start this process.
Each family and patient will have individual needs so there is never a “one fit” program. Looking into each program and deciding what is best for you or your loved one is recommended. It is important to ask as many questions as you need to, to determine if the services offered match you or your loved ones needs.
Resources for Palliative Care and Hospice Care
Canadian Hospice Palliative Care Association - http://www.chpca.net
Canadian Home Care Association - http://www.cdnhomecare.ca/content.php?doc=156
Canadian Virtual Hospice - http://www.virtualhospice.ca
Health Canada - http://www.hc-sc.gc.ca/hcs-sss/palliat/indexeng.php
Hospice International - http://hospiceinternational.com/orgs.htm
There are many organizations, for both palliative care and hospice care, in each province. Searching the internet is a great way to start. The resources above are possible resources to use for information.
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